This Year's Highlights
Expanding Health Care Coverage
2013 was a landmark year for expanding health care coverage, with the October 1 launch of the health insurance marketplaces established as part of the Affordable Care Act (ACA) to enroll millions of uninsured Americans, including more than 1 million New Yorkers, into health care coverage options.
Who is likely to gain coverage through the ACA? A new data visualization of uninsured New Yorkers estimated to enroll in health care coverage is available at www.CoverNYS.org. This interactive map, launched in September 2013, provides a snapshot of the areas and populations with the largest potential gains in coverage.
In 2013, NYSHealth also funded a range of outreach and enrollment efforts to help as many New Yorkers as possible gain health insurance coverage as the ACA is implemented. Ensuring that individuals and small businesses have the resources to understand their insurance coverage options and enroll is integral to the success of health reform.
With support from NYSHealth, the Community Service Society of New York expanded its Small Business Assistance Program to help small businesses across the State get affordable health insurance and learn about their options.
NYSHealth also is supporting a statewide enrollment network of community-based organizations that are conducting education, outreach, enrollment, and referrals, with a focus on communities known to be uninsured at disproportionately high rates.
Through an NYSHealth grant to the Empire Justice Center, the Ambassadors for Coverage program is raising awareness about health insurance options in communities throughout New York with high rates of uninsurance.
Learn more about each of these initiatives and view a statewide map of their locations.
Watch the video above to learn more about NYSHealth’s grantees who are working to expand health care coverage across New York.
Laying the Groundwork for Diabetes Prevention
The increasing numbers of New Yorkers at risk for developing diabetes—estimated at 4.5 million today—led the Foundation to pivot its diabetes-related work toward prevention in 2013. Building on previous work to replicate the National Diabetes Prevention Program (NDPP), NYSHealth awarded the Bridgespan Group a grant to develop a statewide strategy to increase the number of sites offering the program; streamline participant referrals through their primary care providers; and encourage additional insurers to offer reimbursements to ensure sustainability of this evidence-based program.
Through its Laying the Groundwork request for proposals, NYSHealth is working with more than 25 grantee partners to disseminate and grow the NDPP. This evidence-based lifestyle intervention program has been shown help participants lose 5–7% of their body weight and reduce their risk of developing diabetes by nearly 60%.
As part of NYSHealth’s new focus on building the evidence for effective diabetes prevention programs, the Foundation is supporting a team at the University of Chicago to analyze the evidence to date related to diabetes prevention, recommendations for areas of action to help nurture and expand these efforts, and areas where additional evidence is needed to move from research to translation and implementation.
Building Community Health Center Capacity
As the Affordable Care Act goes into effect, community health centers will see new opportunities and challenges. More New Yorkers will be covered by health insurance, but many also will be left out and remain uninsured, so the safety-net system of care epitomized by health centers remains critical.
By 2015, federally qualified health centers (FQHCs) are expected to double capacity to serve nearly 3 million New Yorkers. To help health centers adapt to this changing landscape and prepare for increased demand for services, NYSHealth has supported community health centers’ efforts to provide primary care to some of New York’s most vulnerable populations.
An April 2013 NYSHealth-funded report by the Community Health Care Association of New York State (CHCANYS) offered recommendations for FQHCs to build their capacity and expand their reach. This first-ever plan identified ways for existing health centers to increase productivity, fill vacancies among clinical provider staff, and become more efficient, which could result in more than 1 million additional visits and allow centers to serve hundreds of thousands more patients each year. It also laid out opportunities to build new community health centers and pinpointed neighborhoods and counties throughout the State with both the greatest need and the strongest prospects for supporting new health center sites.
NYSHealth and CHCANYS cohosted a briefing to discuss highlights of the report and how stakeholders can use the findings to achieve greater primary care access for New Yorkers.
Maximizing Veterans’ Health Funding
NYSHealth’s investment in the Syracuse University Institute for Veteran and Military Families (IVMF) helped organizations in New York State to secure $26 million in federal resources through the Supportive Services for Veteran Families (SSVF) program in 2013. The SSVF program supports community-based services to help low-income veterans and their families receive critical social services to prevent them from becoming homeless.
In 2013, New York State more than tripled the amount of funding from the previous year, which was awarded to 23 local organizations. Each organization that secured funding received technical support and program development guidance from IVMF. The foundation for IVMF’s technical assistance is an NYSHealth-funded blueprint, developed by the Veterans Outreach Center, for a scalable best-practice model for serving veterans and their families.
The 23 organizations selected to receive the SSVF funding have continued to receive technical support from IVMF as part of the NYSHealth grant. IVMF focuses on providing guidance on outreach strategies, case management services, the development of Veteran Affairs partnerships, and best practices for providing direct services to veterans and their family members. Ultimately, the SSVF investment in New York State will help to prevent homelessness among 7,000 veteran households.
Through these NYSHealth investments, communities from Long Island to Buffalo now will have the resources to provide high-quality, comprehensive services to New York State veterans and their families.
Recovering from Hurricane Sandy
When Hurricane Sandy hit New York City on October 29, 2012, no one predicted the severity of its impact. By the time it was over, the storm had become an unprecedented catastrophic event. Recognizing the enormity of the storm’s devastation—and the physical, mental, and financial impact it had on survivors—NYSHealth responded by supporting recovery efforts in two key regions: Staten Island and Long Island.
Taking a long view, NYSHealth awarded a grant to the Staten Island Foundation to bolster its health-related recovery efforts and its ability to leverage funding opportunities for the Staten Island community, which helped to transform the organization into the go-to resource for Hurricane Sandy recovery activities on Staten Island. The Staten Island Foundation contributed to the policy recommendations of the federal Hurricane Sandy Task Force, and with NYSHealth’s $50,000 investment, leveraged a $1 million grant from the American Red Cross.
Many Staten Island residents still face physical displacement and psychological distress. When the storm came ashore on Staten Island, it caused catastrophic damage on the east and south shores, causing 23 fatalities—more than any other borough. NYSHealth awarded Staten Island Mental Health Society a grant to address the psychological needs of Staten Island residents.
NYSHealth also supported the Long Island Community Foundation in its efforts to respond to the emerging health-related needs of post-Sandy Long Island. NYSHealth funds were used to provide outpatient mental health services for survivors, with an emphasis on children and families; health and safety training, as well as legal representation, for low-wage workers engaged in rebuilding work; and efforts to document, track, and evaluate the physical and emotional health of elderly survivors.
Hurricane Sandy confirmed the vulnerability of New York’s waterfront communities and the need for resiliency planning for future severe weather occurrences. With funding from NYSHealth, the New York City Environmental Justice Alliance will pursue a Hurricane Sandy recovery agenda that emphasizes an environmentally responsible rebuilding strategy.
Meeting the Mark in Diabetes Care
At the close of 2013, NYSHealth surpassed its five-year goal of helping 3,000 primary care providers (25% of all New York State primary care physicians) attain diabetes recognition, which is an indicator that clinicians are delivering the best care and achieving good outcomes for patients. The initiative supported providers in achieving recognition from the National Committee for Quality Assurance (NCQA) or Bridges to Excellence (BTE) diabetes recognition programs.
When NYSHealth began this work, only 149 New York State providers were recognized for excellence in diabetes care. Studies show that patients treated by providers with NCQA or BTE recognition have lower costs and fewer emergency department visits than patients treated by nonrecognized providers. NYSHealth worked with a wide range of partners to reach its goal: the Healthcare Association of New York State, Community Health Care Association of New York State, and New York Chapter of the American College of Physicians. Through its Meeting the Mark initiative, the Foundation also provided direct support to health care providers for their efforts to achieve recognition for excellent diabetes care.
Data are starting to reflect the efforts made to reverse the State’s diabetes epidemic: care given to Medicare beneficiaries with diabetes is improving and emergency department visits that result in hospital admissions with a primary diagnosis of diabetes are declining. Diabetes continues to be an enormous threat to the State, however; more than 4 million New Yorkers have prediabetes, a condition that puts them at high risk for developing diabetes and its complications. Moving forward, NYSHealth will support effective community-based diabetes prevention programs that reach people where they live, work, and worship.
Learn more about NYSHealth’s efforts to improve diabetes care in the video below.
Fostering Immigrants’ and Refugees’ Health
Improving the health of the most vulnerable New Yorkers, including immigrants and refugees, is an integral part of the Foundation’s mission.
A February 2013 NYSHealth-supported report, “Maximizing Health Care Reform for New York’s Immigrants,” highlighted key opportunities to expand immigrants’ access to health reform. Written by the New York Immigration Coalition in conjunction with the Empire Justice Center, the report made recommendations for State policymakers to preserve and promote immigrants’ access to health care coverage and to mitigate disparities between citizens and noncitizens in health care. It also included recommendations for ensuring access to care for those immigrants who will remain uninsured even after health reform is implemented.
Ninety percent of the State’s refugees, many of whom are survivors of torture, are resettled in upstate New York, with Buffalo as the largest destination. It is home to an estimated 15,000 torture survivors. Despite these numbers, no torture survivor services are offered anywhere in upstate New York. Recognizing that torture survivors require specialized care that is individually tailored and coordinated across multiple domains of assistance, NYSHealth awarded a grant to the Jewish Family Service of Buffalo & Erie County to establish the Western New York Torture Survivor Center in Buffalo, the first of its kind in the region. The center offers an interdisciplinary treatment program to address the complex medical, psychological, immigration, legal, and social service needs of torture survivors.
Integrating Mental Health and Substance Use Services
In New York State, 50% of people who suffer from a mental health disorder are simultaneously struggling with some form of substance use. Yet studies show that fewer than 1 of every 10 residents who have both substance use and mental health conditions (often called co-occurring disorders) receive evidence-based treatment for both conditions. Undiagnosed and untreated co-occurring conditions can lead to painful and costly human and social consequences, such as homelessness, encounters with the criminal justice system, and even suicide.
NYSHealth invested in a five-year initiative to improve the integrated clinical care for people with co-occurring disorders. In 2008, it established the Center for Excellence in Integrated Care (CEIC) to help mental health and substance use programs across the State make changes to address people’s mental health and substance use problems at the same time.
By 2013, CEIC exceeded its target of working with 600 of the estimated 1,000 licensed mental health and substance use programs across the State. An article in the October 2013 issue of Health Affairs examined the clinical aspects of this initiative and provided an analysis of the statewide efforts and impact to improve integrated care. Also in October 2013, NYSHealth hosted a conversation with the CEIC team, other health experts, and a client with co-occurring conditions to discuss the outcomes and lessons learned from this initiative. Learn more about some of the clients and providers affected by the initiative.
Creating Community Connections
NYSHealth is committed to making a difference beyond its grant dollars, which includes being responsive to the changing needs of communities across New York State. New York communities range from urban to rural, and each region faces a unique set of health factors and challenges. In 2013, NYSHealth created the Community Connections initiative as its way to ensure that the Foundation continually expands its reach and deepens its connections throughout the State.
NYSHealth developed seven regional teams comprising staff members and Community Advisory Committee members. Team members conduct outreach throughout the year and visit their region to meet with community members, health experts, policymakers, and others, and get a better understanding of the health needs of the community.
In 2013, each team kicked off its inaugural Community Connections regional visit. The teams visited local health centers, community-based organizations, and other sites, as well as held town hall-style meetings to hear community members’ concerns and provide a new forum for interdisciplinary conversations about how to improve local health outcomes. NYSHealth staff forged many new connections through its outreach efforts and looks forward to continuing the initiative in 2014.
Convening Key Stakeholders
NYSHealth holds a variety of conferences, webinars, and other events each year as part of its commitment to fostering discussion among key stakeholders in health care across New York State. Stakeholders include grantees; community partners; national, State, and local officials; health care advocates; patients; and others. In 2013, the Foundation hosted nearly 40 convenings, from small, invitation-only discussions, to its “A Conversation With…” series, which brings together leaders in the field of health care to discuss issues pertinent to the Foundation’s work, to large conferences on price transparency and population health.
A sampling of 2013 events is below:
Making New York the Healthiest State: Achieving the Triple Aim: In partnership with the New York State Department of Health, NYSHealth cosponsored a population health summit to discuss opportunities to advance population health in New York State and provide insight into public health approaches.
Money Changes Everything II: Creating Price Transparency in New York State: NYSHealth hosted the conference to discuss price transparency and its potential impact on payment reform and cost containment.
A Conversation About Improving Outcomes in Treatment for Co-Occurring Substance Use and Mental Health Disorders: A panel discussed outcomes and lessons learned from NYSHealth’s statewide effort to improve the treatment for people with co-occurring substance use and mental health disorders.
A Conversation About Regional Health Improvement Collaboratives (RHICs): A Return to Health Planning?: Speakers affiliated with the New York State Department of Health held a conversation about RHICs to discuss the role of local health planning.
Payment Reform from a Payer’s Perspective: A Conversation with Mark Wagar: Mark Wagar, president of Heritage Medical Systems and former president and CEO of Empire BlueCross BlueShield, discussed the future of health care payment reform.
Expanding Sustainable Health Centers in New York State: NYSHealth and the Community Health Care Association of New York State cohosted a briefing to discuss highlights from a new analysis on primary care.
The State of New York’s Health Care Quality: NYSHealth and the National Committee for Quality Assurance (NCQA) cohosted a briefing to examine highlights from new NCQA data that analyze the health care quality in New York State.
State Action to Reform Health Care Payment and Delivery: A Conversation with Alan Weil: Alan Weil, executive director of the National Academy for State Health Policy, discussed payment and delivery system reform at the State level.